Dodge, Benjamin M

Dodge, Benjamin M is an individual health care provider with primary practice located at 550Club Lane Suite 1, Conway AR 72034-3681. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Dodge, Benjamin M can be contacted via phone (501) 329-1510.

Contact Information

Primary practice address
550Club Lane Suite 1 Conway AR 72034-3681
Phone: (501) 329-1510
Fax: (501) 329-5697
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X C7472 Arkansas

Profile Details

NPI number 1922090471
LBN Legal business name Dodge, Benjamin M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Nov 5th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922090471 NPPES
Arkansas MEDICAID 123211001
Arkansas Other 12593000000
Arkansas Other 200016131
Arkansas Other 5J081

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